daryl w. weaver, ceo king’s daughters hospital yazoo city, mississippi 662.751.8150
TRANSCRIPT
Daryl W. Weaver, CEOKing’s Daughters
HospitalYazoo City, Mississippi
662.751.8150
Stop the Bleeding in Your Emergency Department
Daryl W. Weaver, CEOKing’s Daughters
HospitalYazoo City, Mississippi
662.751.8150
Lexicon of Southern Dialect “Yamamanim”
A group of familial members and/or friends “Guzinta”
The process of traversing from one local to another, also a mathematical term used in long division (also known as southern calculus.)
Use: When yamamanim guzinta the ED, what will they say about their experience?
Today’s Agenda
Managing Data in Your ED for Success
Alternative Staffing ModelManaging Your Self-Pay Volume
•Front door of the facility•70-80% of admissions•Loss Leader•Significant Source of Revenue Loss•High-Litigation Area•Manage Primary Care/ER Abuse
•Local physicians•Staffing agency•“Any Warm Body” Mentality
The Right Information
Wouldn’t it be nice……to be alerted to a patient issue & address it BEFORE the patient or personal physician calls to complain…and it is the first you’ve heard about it?
Wouldn’t it be nice…
…to know which physicians’ admission and transfer patterns contribute tothe hospital's goals?
The Right Information
Wouldn't it be nice…
… to know how your ED compares to others of like size and complexity?
The Right Information
Wouldn’t it be nice…
…to be been notified about an unexpected complication in the ED on the day it happens?
The Right Information
Wouldn’t it be nice…… to know if your overall ED length of stay is trending up or down?
The Right Information
Wouldn’t it be nice…
… to know that patients are receiving appropriate financial counseling at the time of the visit?
The Right Information
Wouldn’t it be nice…
… to be able to quickly look at ALL of this information for multiple categories including date range, physician, payor class, acuity….?
The Right Information
•Admission/Transfer rates•48 or 72 Hour Return Rates•Emergent/Non-emergent•Length of Stay•Patient Satisfaction•AMA/LWOT•Imaging Discrepancy
•Admission/Transfer rates•48 or 72 Hour Return Rates•Emergent/Non-emergent•Length of Stay•Patient Satisfaction•AMA/LWOT•Imaging Discrepancy
Admission Rates
Goal: 10-12%
Low: Risk Management OpportunityHigh: Over Utilization/RAC Audit
PotentialInclude Observation AdmitsBenchmark Internally and Externally
Transfer Rates
Goal: Depends on Specialty Depth
Too High: Lost Revenue/Lost ReputationTrack by Diagnosis CategoryTrack by Accepting Provider/FacilityFollow Up for EMTALA/DocumentationCorrelate to Admission Rates by
ProviderEvaluate Delays by Cause
Return Rates w/in 72 Hours
Goal: 2%
Too High: Risk Management/Primary Care
Generally Varies by ProviderSome are AppropriateAll Should be ReviewedCorrelate to Admission Rates by
Provider
Acuity Level
Goal: <50% High Acuity
Too High: Lost Revenue on Self PayToo Low: EMTALA/Risk ManagementCompare ProvidersCorrelate to Coded Acuity Levels
Length of Stay
Goal: <2 Hours on Average
Competitive Advantage over UrbanKey Area for Patient SatisfactionCompare ProvidersEvaluate Specific for Transfers
AMA/LWOT
Goal: <4% Combined
Important to Know Why Patients LeaveReview for Screen for EMTALA IssuesTrack Before and After ScreeningNot All Bad
Imaging Discrepancy
Goal: None
PR/Risk Management OpportunityAddress Individually but…Track by Provided/Identify
Deficiencies/Trends
Over-utilization of NightHawk ServiceDiscrete Entry/EDManage+ Will Not ID
•Overall AND Provider Specific•Benchmark Providers •Reliable Retrievable Data
•Admission Rates too Low•Local MDs Resist Admitting
•Medical Staff Resistance•Skill Sets (IM vs Trauma MD)
•OB •Pediatrics• Ortho….
•Loss of Standby Time
•ACLS•ATLS•PALS•NALS •Plus Relevant Experience
•Price isn’t everything•Do They Offer Hospitalist Model?•Set expectations early and in
writing•Review Data with Providers and
Staffing Agency Frequently•Make Data-driven Decisions About
Providers•Don’t Accept Mediocrity
Managing Self-Pay in the ED
“Redirect Program” Non-emergent patients required to make
a deposit toward their final bill Sounds easy, but……. Culture of care Too many handoffs Unpleasant Task
Managing Self-Pay in the ED
Keys to Success… Beware of EMTALA Get ALL players on board (physicians,
nurses and admitting) Provide Clear Policies and Expectations Provide scripting for financial counselors
Thank You!
Daryl W. Weaver, CEOKing’s Daughters Hospital
Yazoo City, Mississippi662.751.8150